Post-traumatic stress disorder (PTSD) as a systemic disorder: Pathways to cardiovascular disease.

Evidence indicates that post-traumatic stress disorder (PTSD) is a significant risk factor for the development and progression of cardiovascular disease (CVD). Most explanations for PTSD-CVD associations conceptualize PTSD as a stress-related mental health disorder that elicits physiological, behavioral, and psychological responses that are causal factors in the development of cardiovascular disorders. This article reviews evidence for the broader physical health consequences of PTSD, and presents a conceptual model based on research suggesting that PTSD is a systemic disorder.

The Impact of Military Emergency Medicine Scholarly Activity.

Background: Emergency medicine is recognized as a critical wartime specialty within the US military. Military emergency medicine contributes to medical literature in unique ways not seen with our civilian counterparts. The impact of this contribution, especially regarding innovations in military medicine, has not been previously examined.

Educating the Leaders and Clinicians of Tomorrow: An Innovative Emergency Medicine Research Curriculum for Resident Physicians.

Academic productivity is a requirement by the Accreditation Council for Graduate Medical Education (ACGME). In addition to the requirements by the ACGME, residency training programs are required to provide education on medical research with the end-goal of teaching physicians how to read, interpret, and apply medical evidence in the form of evidence-based medicine. An understanding of research design, evidencebased medicine, and critical appraisal of available literature is central to practicing medicine and applying new research to clinical practice.

Telemedicine at the Joint Readiness Training Center: Expanding Forward Medical Capability.

Introduction: The US Army's transition from counterinsurgency operations to preparation for large-scale combat operations is likely to bring unique access to care challenges on the battlefield. Ruggedized computer systems exist that allow forward medical personnel to establish telehealth connections with rear-based specialists. We describe our use of one such device during simulated force on force operations at the Joint Readiness Training Center (JRTC).

Prospective Assessment of SARS-CoV-2 Seroconversion (PASS) study: an observational cohort study of SARS-CoV-2 infection and vaccination in healthcare workers.

Background: SARS-CoV-2 is a recently emerged pandemic coronavirus (CoV) capable of causing severe respiratory illness. However, a significant number of infected people present as asymptomatic or pauci-symptomatic. In this prospective assessment of at-risk healthcare workers (HCWs) we seek to determine whether pre-existing antibody or T cell responses to previous seasonal human coronavirus (HCoV) infections affect immunological or clinical responses to SARS-CoV-2 infection or vaccination.

Traumatic Brain Injury Exposure Lowers Age of Cognitive Decline in AD and Non-AD Conditions.

We aimed to detect the possible accelerating role of previous traumatic brain injury (TBI) exposures on the onset of later cognitive decline assessed across different brain diseases. We analyzed data from the National Alzheimer's Coordinating Center (NACC), which provide information on history of TBI and longitudinal data on cognitive and non-cognitive domains for each available subject. At the time of this investigation, a total of 609 NACC subjects resulted to have a documented history of TBI.

POSTERIOR SEGMENT INJURIES IN OPERATION IRAQI FREEDOM AND OPERATION ENDURING FREEDOM: 2001 to 2011.

Background/purpose: To characterize the nature of posterior segment ocular injuries in combat trauma.

Methods: Eyes in the Walter Reed Ocular Trauma Database were evaluated for the presence of posterior segment injury. Final visual outcomes in open-globe versus closed-globe injuries and by zone of injury and the types of posterior segment injuries in open-globe versus closed-globe injuries were assessed.

A Biomechanical Comparison of High-Tensile Strength Tape Versus High-Tensile Strength Suture for Tendon Fixation Under Cyclic Loading.

Purpose: To compare the biomechanical properties of high-tensile strength tape and high-tensile strength suture across 2 selected stitch techniques, the Krackow and whip stitch, in securing tendinous tissue during 5,000 cycles of nondestructive loading followed by a load to failure.

Methods: Fourteen matched pairs each of cadaveric Achilles, quadriceps, and patellar tendons (n = 84) were randomly assigned to either Krackow or whip stitch and sutured with either 2-mm high-tensile strength tape or No. 2 high-tensile strength suture.

Open-globe wounds in operation Iraqi Freedom and Operation Enduring Freedom: risk factors for poor visual outcomes and enucleation.

Purpose: To determine the rates and types of open-globe wounds in soldiers admitted to Walter Reed Army Medical Center from 2001 to 2011 after sustaining combat injuries.

Methods: Data were collected in the Walter Reed Ocular Trauma Database. Inclusion criteria were patients who suffered open-globe injuries.

Time-Course Evaluation of Brain Regional Mitochondrial Bioenergetics in a Pre-Clinical Model of Severe Penetrating Traumatic Brain Injury.

Mitochondrial dysfunction is a pivotal target for neuroprotection strategies for traumatic brain injury (TBI). However, comprehensive time-course evaluations of mitochondrial dysfunction are lacking in the pre-clinical penetrating TBI (PTBI) model. The current study was designed to characterize temporal responses of mitochondrial dysfunction from 30 min to 2 weeks post-injury after PTBI.

Vogt-Koyanagi-Harada disease in a Native American population in Oklahoma.

Purpose: To describe the presentation, features, and outcomes of patients with Vogt-Koyanagi-Harada disease (VKH) seen by uveitis specialists in Oklahoma.

Methods: Clinical data were collected for 26 patients (52 eyes) diagnosed with VKH and seen between 1992 and 2018. Main outcome measures included rates of visual loss, ocular complications, and remission.

The Cardiac Physiology Underpinning Exsanguination Cardiac Arrest: Targets for Endovascular Resuscitation.

Exsanguination leading to cardiac arrest is the terminal phase of uncontrolled hemorrhage. Resuscitative interventions have focused on preload and afterload support. Outcomes remain poor due to several factors but poor coronary perfusion undoubtedly plays a role.

Gamma-Irradiated Cornea in Combat-related Ocular Trauma.

Corneal injury is a known risk for deployed troops worldwide. To the authors' knowledge, there has been no reported use of gamma-irradiated corneas in the setting of severe corneal trauma. Our report highlights the case of a 36-year-old active duty solider who sustained bilateral penetrating ocular trauma from a nearby ordnance explosion.

MicroRNA-Dependent Targeting of RSU1 and the IPP Adhesion Complex Regulates the PTEN/PI3K/AKT Signaling Pathway in Breast Cancer Cell Lines.

(1) Background: The microRNA (miR)-directed control of gene expression is correlated with numerous physiological processes as well as the pathological features of tumors. The focus of this study is on the role of miRs in the regulation of RSU1 and proteins in the IPP (integrin linked kinase, PINCH and parvin) complex. Because the IPP adaptor proteins link β integrins to actin cytoskeleton, and the RSU1 signaling protein connects the complex to the activation of cJun, ATF2 and the transcription of PTEN, their reduction by miRs has the potential to alter both adhesion and survival signaling.

Total Joint Arthroplasty Volume in the Military Health System.

Introduction: The relationship between volume and outcome of total knee arthroplasties is a concern in both the civilian and military patient populations. We sought to compare surgeons and hospital procedure volumes performed on military service members and define factors leading to increased civilian referrals.

Materials And Methods: The Military Health System Data Repository (MDR) contains patient information on all healthcare beneficiary encounters, including care provided both in Military Health System (MHS) facilities and in civilian network facilities.

Vogt-Koyanagi-Harada disease presenting secondary to a post-infectious autoimmune response.

Purpose: To report a rare case of Vogt-Koyanagi-Harada disease likely secondary to post-infectious autoimmune response in a 14-year-old Hispanic female.

Observations: On presentation, visual acuity was 20/400 in the right eye and 20/20 in the left eye. The patient also had bilateral hyperemia, subretinal fluid, and vitreous cell graded at 1+.

Histological Analysis of a Retrieved Porous Tantalum Total Ankle Replacement: A Case Report.

Case: We present a case report documenting the retrieval and histological analysis of a porous tantalum (P-Ta) total ankle replacement (TAR) from a 50-year-old woman after a below-knee transtibial amputation. This rare opportunity to examine an intact TAR may help to better understand the implant-bone relationship because it would be in situ.

Conclusion: In this case study, we demonstrate bone ingrowth to the first layer of the P-Ta and organized trabecular orientation, suggesting that equal bone load was achieved on the base and the rails in both components using a transfibular surgical approach.

Neuro-Ophthalmic Injuries With Systemic Neurologic Injury or Traumatic Brain Injury in Operation Iraqi Freedom and Operation Enduring Freedom.

Background: To analyze the final visual acuity (VA) of neuro-ophthalmologic injuries (NOI) in combat ocular trauma and to study the association of NOI with systemic neurologic injury (SNI) and traumatic brain injury (TBI).

Methods: The Walter Reed Ocular Trauma Database was reviewed. Inclusion criteria were any US service member and Department of Defense civilians who suffered NOI, SNI, or TBI in Operation Iraqi Freedom or Operation Enduring Freedom.

Evisceration Versus Enucleation Following Ocular Trauma, a Retrospective Analysis at a Level One Trauma Center.

Introduction: Penetrating and perforating ocular trauma is often devastating and may lead to complete visual loss in the traumatized eye and subsequent compromise of the fellow eye. Enucleation is commonly utilized for management of a non-salvageable eye following penetrating and perforating ocular injuries. Recently, the use of evisceration for non-salvageable traumatized eyes has increased.

Refractive surgery in the HIV-positive U.S. Military Natural History Study Cohort: complications and risk factors.

Purpose: This study sought to assess the frequency of refractive surgery complications in HIV+ individuals and related risk factors.

Settings: Multiple centers in the United States.

Design: Prospective observational cohort study.

Orbital Fractures and Associated Ocular Injuries in Operation Iraqi Freedom and Operation Enduring Freedom Referred to a Tertiary Care Military Hospital and the Effect on Final Visual Acuity.

Purpose: To update the incidence of orbital fractures in U.S. Soldiers admitted to the former Walter Reed Army Medical Center from 2001 to 2011 after sustaining combat injuries in Operation Iraqi Freedom and Operation Enduring Freedom.

Sixteen year-old with leiomyosarcoma in a prior benign myomectomy site.

Uterine leiomyosarcoma in a prior myomectomy site is a rare phenomenon. We report an unusual case of a leiomyosarcoma arising six months post myomectomy in a 16-year old female.